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Pathogenesis of pancreatic sepsis
D S Medich1, T K Lee, M F Melhem
1Department of Surgery, University of Pittsburgh School of Medicine, Pennsylvania.
American Journal of Surgery
|January 1, 1993
Summary
Acute pancreatitis promotes bacterial translocation, leading to pancreatic infections. This study in rats suggests gut decontamination and peritoneal lavage may prevent these serious complications.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Pathophysiology
Background:
- Pancreatic sepsis is a major cause of mortality in acute pancreatitis.
- The mechanisms driving pancreatic infections remain poorly understood.
- Inflammation can promote bacterial translocation from the gut.
Purpose of the Study:
- To investigate if acute pancreatitis induces bacterial translocation.
- To determine the route of bacterial migration to the pancreas.
- To provide evidence supporting preventative strategies for pancreatic infections.
Main Methods:
- Acute pancreatitis was induced in a rat model.
- Translocation of live bacteria to organs was assessed.
- Oral administration of fluorescent beads tracked gut barrier integrity.
- Bacterial and bead presence in the pancreas and lymph nodes was quantified.
Main Results:
- Live bacteria were found in 33% of pancreata in rats with acute pancreatitis.
- Fluorescent beads, indicating translocation, were present in 91% of pancreata.
- Beads were absent in mesenteric lymph nodes, suggesting a transperitoneal route.
- No bacteria or beads were detected in control rat pancreata.
Conclusions:
- Acute pancreatitis facilitates bacterial translocation into the pancreas.
- Infection appears to occur via a transperitoneal route.
- Findings support selective gut decontamination and peritoneal lavage for prevention.